An analysis of 52 studies from 18 countries indicates that mortality among pneumonia patients admitted to intensive care units (ICUs) remains high in low- and middle-income countries (LMICs), researchers reported last week in NEJM Evidence.

The systematic review and meta-analysis, conducted by researchers in Brazil, aimed to synthesize current evidence on mortality in patients with community-acquired pneumonia (CAP) admitted to an ICU. 

CAP is already known to be a leading cause of ICU admission and a major contributor to mortality in LMICs, despite advances in diagnostics, antibiotic therapy, and organ support. With the population of people 65 and older expected to triple in LMICs in coming years, the researchers wanted to get a better understanding of CAP outcomes.

“The convergence of population aging and high CAP incidence will likely amplify ICU demand, strain workforce capacity, and increase the economic and social burden of disease through prolonged disability, absenteeism, and productivity loss,” they wrote.

37% pooled mortality rate

The included studies had data on 48,707 CAP patients (mean age, 65.4 years; 60.8% male) from 18 countries. Nearly half of the studies (25) were conducted in China. 

The most frequent comorbidities were hypertension, chronic obstructive pulmonary disease, and diabetes. Streptococcus pneumoniae was the most commonly identified pathogen in the 22 studies with microbiologic information. The researchers also noted high rates of smoking in study populations.

The convergence of population aging and high CAP incidence will likely amplify ICU demand, strain workforce capacity, and increase the economic and social burden of disease through prolonged disability, absenteeism, and productivity loss.

The pooled short-term (28- and 30-day) mortality rate was 37.1%, rising to 61% among patients who required mechanical ventilation. Further analysis showed that age and mechanical ventilation were the biggest predictors of mortality.

The authors say the observed mortality rate among patients in LMIC’s is higher than that previously reported in large multinational cohorts that included data from high-income countries. 

“These differences likely reflect case-mix but also variation in care delivery, resource availability, and delays in ICU admission,” they wrote. “Such variability underscores the importance of contextualized data to inform national policies.”

As soccer fans prepare to descend upon North American cities to watch their favorite teams compete in the World Cup, the Los Angeles County Department of Public Health issued an alert encouraging healthcare providers to be mindful of travel-related, sexually transmitted, and seasonal infectious diseases. 

From June to July 2026, an estimated 150,000 national and international fans will likely visit the county to watch the eight games occurring at SoFi Stadium and attend fan festivals. 

This coincides with Pride Month, another time of year when large public gatherings take place. This convergence could enable spread of travel-associated infections, emerging infections, sexually transmitted infections (STIs), and seasonal diseases, officials warn. 

Infectious, heat-related diseases and overdoses

As people gather, it’s easier for infectious diseases to flourish. Los Angeles County asks providers to look out for infectious illnesses such as: 

• Influenza A and COVID-19
• Measles, pertussis, mumps, and other vaccine-preventable illnesses 
• Gastrointestinal (GI) conditions (eg, norovirus) 
• STIs (eg, mpox, chlamydia, gonorrhea, syphilis) 
• Infectious diseases related to travel (eg, dengue, chikungunya, malaria) 

The flu season in the Southern Hemisphere lasts from April to September, which means some fans could import and spread influenza. 

The public health department reminds providers that they must report conditions on this list. Doctors and nurses should ask patients about their travel history, both international and domestic, and about their attendance at games, festivals, and other celebrations. Providers who notice patterns such as a spike in GI conditions or respiratory illness should also report them to the health department. 

Officials also note that people spending long days outside could be more likely to experience dehydration and other heat-related illnesses (eg, exhaustion, fainting, heat stroke). During large public celebrations, accidental overdoses occur more frequently; attendees can find free naloxone (eg, Narcan) at Fan Zones and health stations.  

Attendees can visit Winning Starts with Staying Safe to learn how to protect themselves from infectious diseases, heat-related illnesses, and overdoses. 

The Florida Department of Health said there have been 154 measles cases in the state this year, with the most recent cases identified in Orange and Palm Beach counties. 

The total comes from cases reported in 15 counties through May 23 and is the highest number of cases reported in the state in a single year over the last 25 years. Most of the cases come from Collier County, where Ave Maria University reported an outbreak in January and February of this year.

According to the Centers for Disease Control and Prevention, Florida is fourth overall for 2026 measles infections, behind South Carolina, Utah, and Texas. 

In related news, the Pan American Health Organization (PAHO) has released an updated epidemiological review of measles activity in the Americas region. A total of 20,521 measles cases were confirmed in the Americas Region, including 25 deaths, in the first five months of the year in 16 countries.

Mexico has the highest case count so far this year with 10,920, followed by Guatemala (6,209), the United States (1,952), and Canada (1,018 cases). To compare, in 2025, 15,152 measles cases were confirmed in the Americas Region, including 29 deaths.